The influence of resting heart rate on pulse wave velocity measurement is mediated by blood pressure and depends on aortic stiffness levels: insights from the Corinthia study

Abstract

Objective: Increased resting heart rate as well as increased arterial stiffness are both independent predictors of cardiovascular events and mortality. Results of previous studies have failed to converge concerning the association between heart rate and arterial stiffness, regardless of other potential confounders, such as age, gender and particularly blood pressure (BP). We aimed to investigate: (a) the degree of association (if any) between resting heart rate and carotid-to-femoral pulse wave velocity (PWV), the gold standard index of arterial stiffness, (b) if the relationship between heart rate and PWV is mediated by BP levels and (c) whether their association is affected by the levels of aortic stiffening. Approach: Demographic, hemodynamic, laboratory and clinical data of 1566 subjects from the cross-sectional observational 'Corinthia' study were analyzed using univariate and multivariate regression models. Mediation analysis was performed to test whether mean arterial pressure (MAP) is a significant mediator in the heart rate-PWV relationship. The total population was divided in two groups of low and high arterial stiffness according to the median PWV value (8.6 m s −1 ). Main results: We found that (i) there is a significant association between heart rate and PWV, regardless of other confounding factors. An increase in heart rate by 20 b.p.m. can increase PWV by 0.5 m s −1 . However, this association was significant only for subjects with increased aortic stiffness (PWV > 8.6 m s −1 ) and not for those with PWV ⩽ 8.6 m s −1 . Further, (ii) heart rate-PWV association was partially mediated by MAP. Significance: Increased resting heart rate is related to increased aortic stiffness, only in subjects with stiffer aortas, regardless of BP and other risk factors and subjects' characteristics. The synergistic prognostic effect of increased arterial stiffness and elevated heart rate on target organ damage, cardiovascular events and mortality should be explored in future studies.

Associations between Intrinsic Heart Rate, P Wave and QT Interval Durations and Pulse Wave Analysis in Patients with Hypertension and High Normal Blood Pressure

“…The influence of heart rate on PWV measurements remains controversial, with conflicting results observed in both acute and epidemiological studies [ 30 , 31 , 32 , 33 ]. A significant blood pressure independent association between heart rate and PWV was mentioned [ 33 ], significant only for subjects with increased aortic stiffness [ 34 ]. A higher resting heart rate was independently associated with arterial stiffness in healthy Korean adults [ 35 ].…”

Factors Associated with Brachial-Ankle Pulse Wave Velocity in an Apparently Healthy Chinese Population

“…The effects of the RHR on PWV are still controversial, with conflicting results being observed. Some researchers in the Corinthia study suggested that the influence of the RHR on PWV is mediated by BP [41], and the product of the RHR times the BP was reported to be associated with baPWV [42]. However, approximately half of the existing epidemiological studies have reported a significant BP-independent association between the RHR and PWV [43].…”

Noninvasive estimation of aortic hemodynamics and cardiac contractility using machine learning

“…The total dataset (organized in pairs of inputs and outputs) was kept for the training/testing process. The carotid-to-femoral pulse wave velocity (cfPWV) was measured in every subject as previously described [76][77][78] . In brief, cfPWV measurement was performed using the SphygmoCor apparatus (AtCor Medical Pty Ltd, West Ryde, Australia).…”